Managing chronic insomnia with RX meds while on TPAPN?

Nurses Recovery

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So I’m going to start Texas’ peer assistant program and clearly drug testing is going to be a part of it. I’ve been reading through the information packet and it’s very, very sensitive to just about everything. They go to the point of even saying I’d need to steer clear of a poppyseed bagel.
Thing is I have chronic insomnia and I’ve tried everything under the sun and the only thing that has work -which I have a prescription for - is Ambien. Is this really going to screw my testing?

Also does TPAPN take into consideration what we’re being tested for? I was referred to them because of ETOH, not drugs. And Ambien’s technically a hypnotic & not a benzo.

Anyone else been prescribed controlled substances on a regular basis while they were enrolled?

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Specializes in tele, ICU, CVICU.

I'm not sure if Texas is different than PA (where I am) but our contract states abstinence from any mood-altering substance, medications included. Ambien was included in that list, despite having a valid prescription from a doctor.

However, I also know I've seen other folks on anxiety/PTSD meds that would show on a urine test, but they were allowed. I know a part of it depended on the reason you were being monitored (substance use versus psychiatric care- ie a suicide attempt). Sorry if that sounded callous, just some of what I've seen/heard of here.

I imagine this is something you'd have to discuss with your case manager, but I wouldn't hold my breath.

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Specializes in Med/Surg, Women's Health, LTC.

I am in TPAPN. I had to submit a list of all my meds and they were either approved or not approved by my CM. I do not take anything that will show up on a UDS, however, in my list of not allowed, Ambien is there.

Talk to your CM and see what he/she says. Even with a prescription, they can say it is not allowed.

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Specializes in OR.
On 4/10/2020 at 9:17 AM, rn1965 said:

I am in TPAPN. I had to submit a list of all my meds and they were either approved or not approved by my CM. I do not take anything that will show up on a UDS, however, in my list of not allowed, Ambien is there.

Talk to your CM and see what he/she says. Even with a prescription, they can say it is not allowed.

Despite the anxiety diagnosis (forced 12 step meeting attendance was great at inducing that issue to the point that my therapist recommended that stipulation be removed....that of course was ignored, shocking I know...) the only PRN anxiety med I was permitted (even though we are told that the program does not tell our doctors what they can and can’t prescribe....yeah, whatever....) was Visteril. That’s stuff made me feel nasty. We finally settled on a scheduled low dose of Gabapentin which, now that I am no longer in the clutches of the program, I am no longer on....

I would not seriously get your hopes up on them letting you take anything that can remotely be ‘abused’ in some manner....but of course ask.

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Specializes in cardiac and geriatrics.

well this is not good news for me then either. I have been on restoril on and off for many years now. only get prescribed 8-10-12 pills a month (to reduce ability to OD or abuse) anyway. I had it on my list of medications also. yesterday my contract came via email and NOPE restoril is NOT on the list. my contract reads same as above: no mood altering drugs , ect... also abstinence from alcohol. rather irritating as a margarita now and then is rather refreshing. not a drinker anyway. but , really? this to me is not a monitoring program. they are dictating much more than how and when we are being n. denying a person their perscribed meds is nuts. so with insomnia, are we suppose to do OT shifts if no sleep the night before because we are not allowed to get what we need to maintain our own stability? I am feeling so defeated.

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Honestly I am going to fight that tooth and nail. They are not going to dictate what prescriptions I take. I will hire a lawyer if I have to.

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Specializes in tele, ICU, CVICU.
50 minutes ago, AesthesiaSeeker said:

Honestly I am going to fight that tooth and nail. They are not going to dictate what prescriptions I take. I will hire a lawyer if I have to.

I felt the same way too when I first heard. "No exceptions!" was all my CM would say. If I wanted to keep my license, I had a decision to make.

Hopefully you're successful in fighting them. Let us know!

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Specializes in OR.

These programs (despite the claim that "they don't tell your doctor's what they can and can't prescribe") don't care one whit why you are in their clutches. They don't care what worked for you before or what you may need to function. They have exactly one profile. That of a person with the disease of addiction who could relapse any second. Individualized contracts, yeah no. Not, even.

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So I can’t be in TPAPN because I take sleep meds for insomnia and have been for the past twelve years? What next, are they going to tell me I can’t join because I have autism? Because I have that too, and that f’s with my life way more than my drinking ever has or could.

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Specializes in tele, ICU, CVICU.

They say (at least here in PA) they look at everyone one a 'case by case basis' but I fail to see that, as I think many others would agree. You can certainly try with your own case manager, plead your case, with being on ambien for over a decade. Maybe medical records & a letter from your doc would help, it won't hurt to try. And yes, they request medical records, diagnosis & all medications you are on. And you have to submit them as requested. We even need an RX for benadryl or OTC allergy meds. No HIPAA here!

I think most of us are just sharing our experience that it was their (the programs') way or the highway and in order to keep our license & do what we love, made the choice to do it their way. It is BS, I couldn't agree more. But they have you by your short & curlies & don't seem to answer to anybody.

But please do try & fight them. Maybe you will win & give some encouragement to us & others that things can change. Let us know what happens! ?

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Specializes in Clinical Leadership, Staff Development, Education.

Ambien will most likely be a difficult win due to the high rate of misuse. I know you said tried everything, but to even consider, the board will probably ask for records showing each med that was tried, follow up visits ect.

I was prescribed trazodone in treatment and continue to take for sleep. The board has not questioned as long as I submit prescription verification form. But, it is also not controlled med.

Good luck!

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Specializes in ED RN and Case Manager.

I have narcolepsy & have been on Adderall for years. It was certainly a banned medication in KY’s KARE program. However, they allowed if if my Physician signed Prescription Monitoring Form with each fill. My physician had no problem with this & I took this medication for the 5 years that I was in the program. I had many Positive drug tests but no issues since my CM had the documentation on file.

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